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Causes and Consequences of Adult Obesity: Health, Social and Economic Impacts in the United States
Abstract
Obesity has been identified as an epidemic in the United States for more than two decades and yet the numbers of overweight and obese adults and children continue to grow. Currently, the rates of both overweight and obesity in the US are 61% and 14% in adults and children, respectively. Among US adults aged 20-74 years, the prevalence of overweight (defined as BMI 25.0-29.9) has increased from 33% in 1980 to 35% of the population in 1999. In the same population, obesity (defined as BMI >/= 30) has nearly doubled from approximately 15% in 1980 to an estimated 27% in 1999. The percentage of children and adolescents who are defined as overweight has more than doubled since the early 1970s. About 14% of children and adolescents are now seriously overweight. Obesity burdens the health care system, strains economic resources, and has far reaching social consequences. The disease is associated with several serious health conditions including: type 2 diabetes mellitus, heart disease, high blood pressure and stroke. It is also linked to higher rates of certain types of cancer. Obesity is an independent risk factor for heart disease, hypoxia, sleep apnea, hernia, and arthritis. Obesity is the seventh leading cause of death in the US. The total cost of overweight and obesity by some estimates is 70 billion. Other annual costs associated with obesity are 40 million workdays of productivity lost, 63 million doctors' office visits made, and 239 million restricted activity days and 90 million bed-bound days. Emotional suffering may be among the most painful aspects of obesity. American society emphasizes physical appearance and often equates attractiveness with slimness, especially for women. Such messages may be devastating to overweight people. Many think that obese individuals are gluttonous, lazy, or both, even though this is not true. As a result, obese people often face prejudice or discrimination in the job market, at school, and in social situations. Feelings of rejection, shame, or depression are common. Since the 1950s, national dietary recommendations have come to acknowledge obesity as a significant societal trend. The Surgeon General's 2001 Call To Action, Healthy People 2010, and the Dietary Guidelines for Americans 2000 all emphasize the importance of healthy weight. There are some new tools available to help in the fight against overweight and obesity: Weight Control Information Network, The Third National Cholesterol Education Program's Adult Treatment Panel, and The Practical Guide: Identifi-cation, Evaluation, & Treatment of Overweight & Obesity in Adults from the National Institutes of Health and National Heart Lung and Blood Institute.
... Obesity is defined as a body mass index (BMI) >30 kg/m 2 and classified as a disease by the WHO. Obesity is a risk factor for a range of diseases, including high blood pressure, stroke, heart disease, type 2 diabetes, certain types of cancer and arthritis [27,28]. Further, obesity decreases quality of life, strains health care systems and society [27]. ...
... Obesity is a risk factor for a range of diseases, including high blood pressure, stroke, heart disease, type 2 diabetes, certain types of cancer and arthritis [27,28]. Further, obesity decreases quality of life, strains health care systems and society [27]. In pregnancy, a BMI of 30 kg/m 2 and above in the first trimester is defined as obesity, a BMI of 25.0-29.9 ...
Low-grade inflammation is often present in people living with obesity. Inflammation can impact iron uptake and metabolism through elevation of hepcidin levels. Obesity is a major public health issue globally, with pregnant women often affected by the condition. Maternal obesity is associated with increased pregnancy risks including iron deficiency (ID) and iron-deficiency anaemia (IDA)—conditions already highly prevalent in pregnant women and their newborns. This comprehensive review assesses whether the inflammatory state induced by obesity could contribute to an increased incidence of ID/IDA in pregnant women and their children. We discuss the challenges in accurate measurement of iron status in the presence of inflammation, and available iron repletion strategies and their effectiveness in pregnant women living with obesity. We suggest that pre-pregnancy obesity and overweight/obese pregnancies carry a greater risk of ID/IDA for the mother during pregnancy and postpartum period, as well as for the baby. We propose iron status and weight gain during pregnancy should be monitored more closely in women who are living with overweight or obesity.
... According to Wellman and Friedberg (2002), one of these adverse health conditions is type 2 diabetes. Studies have shown that any weight gain-whether small or large-is associated with a higher risk of developing this disease. ...
... In fact, a small weight gain of eleven to eighteen pounds has been shown to double one's risk of developing type 2 diabetes, while a large weight gain of 44 pounds has been shown to quadruple one's risk (Wellman and Friedberg 2002:S706). Wellman and Friedberg (2002) also mention that obesity increases a person's risk of dying; in fact, they state that at the time of publication of their article, obesity was the "seventh leading cause of death in the US" (2002:S206). Studies have also demonstrated that obesity is associated with a higher chance of developing certain cancers, such as uterine, gallbladder, and kidney (Bhaskaran et al. 2014). ...
... Unfortunately, however, these initiatives appear to have met with little to no measurable success 18,19,20,21 . Obesity remains a major contributor to the global burden of a disease 22 and is linked to a range of associated health problems, including coronary heart disease, dementia, Type II diabetes, certain cancers, and increased overall risk of morbidity 22,23,24,25,26,27 . The sharp rise in obesity and associated health conditions over recent decades 28 has been linked with the availability of cheap, energy-dense foods 18,29 . ...
... Unfortunately, however, these initiatives appear to have met with little to no measurable success 18,19,20,21 . Obesity remains a major contributor to the global burden of a disease 22 and is linked to a range of associated health problems, including coronary heart disease, dementia, Type II diabetes, certain cancers, and increased overall risk of morbidity 22,23,24,25,26,27 . The sharp rise in obesity and associated health conditions over recent decades 28 has been linked with the availability of cheap, energy-dense foods 18,29 . ...
... For example, in Germany about 40% of the population older than 18 does not participate in sports activities at all, which is about the average for Europe (see Deutscher Bundestag, 2006;Gratton and Taylor, 2000). A similar pattern appears in the USA (see Ruhm, 2000;Wellman and Friedberg, 2002). These non-activity figures are surprisingly high considering that many Western countries subsidize the leisure sports sector substantially (Gratton and Taylor, 2000, provide some details). ...
... In particular obesity is becoming wide spread (e.g., Andreyeva et al., 2005). It increases the risk of mortality, diabetes, high blood pressure, asthma, and other diseases, and thus drastically reduces labour productivity (e.g., Wellman and Friedberg, 2002, and the references given in Ruhm, 2007). ...
... About 14% of children and adolescents are now seriously overweight." [10] There're a lot of medical problems associated with obesity, including: Mortality:-Obesity reduces life expectancy by six to seven years. [11] Morbidity: ...
... Feelings of rejection, shame, or depression are common." [10] Low Self-Esteem [13] :-Obese teens have significantly lower self-esteem than teens of normal weight. Low self-esteem often appears as loneliness, nervousness and sadness. ...
... About 14% of children and adolescents are now seriously overweight." [10] There're a lot of medical problems associated with obesity, including: Mortality: ...
... Feelings of rejection, shame, or depression are common." [10] Low Self-Esteem [13] Obese teens have significantly lower self-esteem than teens of normal weight. Low self-esteem often appears as loneliness, nervousness and sadness. ...
... Originally associated with affluent nations, obesity is now a global epidemic with a rapid increase observed in recent decades [14], which worsened during the COVID-19 pandemic [15,16]. Of note is that, in the USA, obesity rates are increasing more rapidly in children and adolescents than in adults [17][18][19]. ...
Histones are slowly evolving major chromatin components and chromatin remodeling can incorporate histone variants which differ from canonical histones primary sequences as an epigenetic modification. Several identified histone variants are involved with the environmental stress-induced DNA damage response (DDR). Mechanisms of DDR are better understood in somatic cells than in transcriptionally inactive, prophase-arrested oocytes and epigenetic regulation is under-explored in ovarian toxicology. The objective of this study was to identify ovarian proteomic and histone modifications induced by DMBA exposure and to examine any influence of obesity thereon. Post-pubertal wildtype (KK.Cg-a/a; lean) and agouti (KK.Cg-Ay/J; obese) female mice, were exposed to either corn oil (CT) or DMBA (1 mg/kg) for 7d via intraperitoneal injection (n = 10/treatment). Total ovarian proteome analysis (LC–MS/MS) determined that obesity altered a total of 225 proteins (P < 0.05) and histone 3 was the second least abundant protein (FC = −5.98, P < 0.05). Histone 4 was decreased by 3.33-fold whereas histone variant H3.3 was decreased by 3.05-fold and variants H1.2, H1.4 and H1.1(alpha) were increased by 1.59, 1.90 and 2.01-fold, respectively (P < 0.05). DMBA exposure altered 48 proteins in lean mice but no alterations in histones or histone variants were observed. In obese mice, DMBA exposure altered 120 proteins and histone 2B abundance was increased by 0.30-fold (P < 0.05). In DMBA-exposed mice, obesity altered the abundance of 634 proteins. Histones 4, 3 and 2A type 1-F were decreased by 4.03, 3.71, 0.43-fold, respectively, whereas histone variant H1.2 and linker histone, H15 were increased by 2.72- and 3.07-fold, respectively (P < 0.05). Thus, histones and histone variants respond to DMBA exposure, and this response is more pronounced during obesity, potentially altering ovarian transcriptional regulation.
... This effect may be explained through the minority stress model, with the activation of a "vicious cycle", wherein weight stigma begets weight gain, perpetuating the condition of overweight/obesity and facilitating the internalization of weight stigma and the subsequent occurrence of negative outcomes [13,14]. Not surprisingly, both obesity and weight bias internalization have been associated with multiple negative health-related outcomes including depression, anxiety, low self-esteem, poor body image, disordered eating, emotional difficulties, and suicidal ideation [15][16][17][18]. ...
Purpose
Health-related quality of life (HRQOL) refers to an individual's perception of their physical and mental health status over time. Although emerging evidence has documented a negative association between weight stigma (i.e., negative weight-related attitudes and beliefs towards individuals with overweight or obesity) and mental HRQOL, its influence on physical HRQOL still needs to be fully clarified. This study aims to investigate the impact of internalized weight stigma on mental and physical HRQOL by employing a structural equation modeling (SEM) approach.
Methods
The Short Form Health Survey 36 (SF-36) and the Weight Bias Internalization Scale (WBIS) were administered to a sample of 4450 women aged 18–71 (Mage = 33.91 years, SD = 9.56) who self-identified in a condition of overweight or obesity (MBMI = 28.54 kg/m²; SD = 5.86). Confirmatory factor analysis (CFA) was conducted to assess the dimensionality of the scales before testing the proposed structural model.
Results
After establishing the adequacy of the measurement model, SEM results revealed that internalized weight stigma was significantly and negatively associated with both mental (β = − 0.617; p < 0.001) and physical (β = − 0.355, p < 0.001) HRQOL.
Conclusion
These findings offer additional support to prior research by confirming the association between weight stigma and mental HRQOL. Moreover, this study contributes to the existing literature by strengthening and extending these associations to the physical HRQOL domain. Although this study is cross-sectional in nature, it benefits from a large sample of women and the use of SEM, which offers advantages over traditional multivariate techniques, e.g., by explicitly accounting for measurement error.
Level of evidence: Level V, descriptive cross-sectional study.
... Although body mass index, body fat percentage, low density lipoprotein oxidation and triglyceride levels are important indicators of oxidative stress, they are associated with obesity as well as parameters. A diet rich in fat and carbohydrates has been found to induce significant oxidative stress and inflammation in obesity [18]. It has been determined that reactive oxygen compounds may cause insulin resistance by negatively affecting the balance of insulin secretion in the pancreas and glucose transport system in skeletal tissue and adipose tissue [19,20]. ...
Objectives: Obesity is a complex multifactorial disease with recently increasing prevalence and incidence. Several studies have been conducted to explain the ethiology, pathophysiology, epidemiology, molecular and genetic mechanisms, and effective treatments of obesity. Glutathione S-transferase (GST) S1, GSTZ1, and GSTT1 are essential enzymes for oxidative stress and metabolism-related disorders. For this purpose, we aimed to reveal the role of GSTS1, GSTZ1, and GSTT1 in obesity. Methods: The gastric tissue samples were taken from the patients diagnosed with obesity who underwent bariatric surgery in Ankara Keçiören Training and Research Hospital General Surgery Clinic between 2017 and 2019. Immunostaining was performed on paraffin-embedded tissues to evaluate GSTS1, GSTZ1, and GSTT1 expressions. Laboratory data of the patients were recorded. All the results were analyzed statistically. Results: Weak GSTS1 expression was observed in 38.1% of tissues and moderate in 6.3%. 37.3% of the tissues presented weak GSTZ1 expression, and 11 (8.7%) displayed moderate. There were weak GSTT1 expressions in 7.1% of the tissues and moderate 0.8% of them. A positive and statistically significant correlation was observed between GSTS1 and GSTT1 expression levels ((r)=0.028, p = 0.010; p < 0.05). There were no significant differences between expression levels and gender, age, comorbidities, and medication usage (p > 0.05). Conclusions: GSTs, in particular GSTS1, GSTT1, and GSTZ1, might contribute to molecular mechanisms and the progression of obesity. In our study, GSTS1, GSTT1, and GSTZ1 were found to be moderately expressed in gastric tissues taken from obese patients. However, new studies using more samples and advanced techniques are needed to elucidate the relationship.
... The capacity of the antioxidant defense system decreases according to the level of fat percentage in the body. A diet high in fat and carbohydrates has been shown to induce oxidative stress and inflammation in obese subjects significantly [5]. It has been stated that oxidative stress may cause insulin resistance, which is a common condition in obesity, by disrupting insulin secretion from β-cells in the pancreas and glucose transport in skeletal and adipose tissue [6]. ...
Metabolik işleyiş, etkileri ve neden olduğu hastalıklar açısından daha multidisipliner bir bakış açısıyla anlaşılması gereken obezite, son yıllarda prevalansı ve insidansı artan hastalıklardan biri olarak görülmektedir. Bu hastalığın metabolik yolunda önemli enzim gruplarından biri olan sitokrom p450 (CYP1A1 ve CYP1B1) izozimlerinin rolünün ortaya konulması amaçlanmıştır. 2017-2019 yılları arasında Ankara Keçiören Eğitim ve Araştırma Hastanesi Genel Cerrahi Kliniği'nde obezite tanısı konulan ve bariatrik cerrahi, ksenobiyotik metabolizması uygulanan 152 hastaya immünohistokimya yöntemiyle CYP1A1 ve CYPB1 izoenzimlerinin ekspresyonu araştırılmıştır. CYP1A1 açısından elde edilen bulgular; 152 kişide CYP1A1 ve CYP1B1 immünohistokimya boyama düzeyleri incelenen dokuların %12.7'sinde CYP1A1 ekspresyonu gözlenmezken; %33.3, %32.5 ve %21.4'te zayıf bir CYP1A1 ifadesi gözlenmiştir. Dokuların %71.4'ünde CYP1B1 ekspresyonu görülmezken, dokuların %28.6'sında zayıf ekspresyon izlenmiştir. Hiçbir dokuda orta veya güçlü CYP1B1 ekspresyonu gözlenmemiştir. Kadın hastalardan alınan dokuların ortalama CYP1A1 ve CYP1B1 boyama seviyeleri erkek hastalardan daha yüksek bulunmuştur. Klinik verilerden diyabet parametresi (p
... It is worth noting that the weight gain in the foodservice sector among food handlers and the high turnover make it difficult to monitor these employees throughout their working lives. Overweight and obesity are associated with several clinical conditions such as diabetes and hypertension and social consequences such as feelings of rejection, shame, depression, and discrimination in the job market (38). Negative outcomes associated with obesity in the labor market are frequent. ...
This study aimed to evaluate the association between the years of work of food handlers in the foodservice and excess weight among Brazilian low-income food handlers. A total of 559 food handlers from all Brazilian regions were characterized using a questionnaire. Weight and height were measured to estimate the Body Mass Index and classify the individuals. The association between food handlers' years of work in the foodservice, anthropometric status, and other variables (gender, age group, educational level, participation in a government program and per capita income at home and energetic consumption) were performed using Pearson's chi-square test (p < 0.05). Multinomial logistic regression analyses were performed (p < 0.05) as well as sensitivity tests using the outcome continuously and transformed, excluding underweight individuals, in a multivariate linear regression model. Most of the sample was female (63.1%), aged between 21 and 40 years old (63.5%), and 53.3% had studied up to complete elementary school. Almost 41% of the food handlers had less than half the minimum wage per capita income. Of the evaluated individuals, 59.9% presented excess weight. There was an association with family per capita income (Odds Ratio - OR: 1.73; Confidence interval - CI95%: 1.09–2.75); handlers whose per capita income was ≤0.5 minimum wage had a 73% higher chance of obesity than those with higher income. Working in foodservive ≥3 years increased the chance of being overweight by 96% compared to those who work for <3 years (OR: 1.96; CI95%: 1.11–3.49). No significant association was found between the years of work of food handlers in the foodservice and obesity. Since work-related factors may contribute to the high prevalence of excess weight, including working in a food handling environment, the government and employers should consider workplace interventions. These would guide the food handlers in avoiding high rates of excess weight and their consequences on public health. Excess weight is an important driver of costs in the workplace associated with absenteeism, job change, and diseases. More studies are necessary to clarify the relationship between the factors related to work and the anthropometric status of food handlers since excess weight is multifactorial.
... Obesitas dikaitkan dengan beberapa kondisi kesehatan serius, diantaranya yaitu diabetes mellitus tipe 2, penyakit jantung, tekanan darah tinggi (hipertensi), dan stroke (Wellman & Friedberg, 2002). Menurut Hadi (2004), obesitas juga merupakan salah satu penyebab peningkatan risiko kematian. ...
Kondisi obesitas menimbulkan dampak dan konsekuensi negatif kepada individu yang mengalaminya. Dampak negatif yang dirasakan oleh individu obesitas antara lain: dampak fisik, seperti meningkatnya resiko mengalami penyakit kronis, dampak psikologis, seperti merasa kurang percaya diri, dan dampak sosial berupa hambatan dalam berinteraksi dengan orang lain di lingkungan sosial. Kondisi tersebut membuat individu yang mengalami obesitas perlu melakukan tindakan pencegahan agar tidak mengalami dampak negatif dari obesitas. Tindakan untuk menjaga kesehatan melalui upaya pencegahan dinamakan juga dengan preventive health care behavior. Ada beberapa faktor yang berperan terhadap preventive health care behavior, salah satunya adalah health consciousness (kesadaran kesehatan). Penelitian ini bertujuan untuk mengetahui peran health consciousness terhadap preventive health care behavior pada individu dewasa awal yang mengalami obesitas. Penelitian ini menggunakan pendekatan kuantitatif. Sampel penelitian berjumlah 82 partisipan usia dewasa awal yang mengalami obesitas di wilayah JABODETABEK. Teknik pengambilan sampel adalah accidental sampling. Instrumen pengumpulan data yang digunakan adalah Health Consciousness Scale (?= 0.880) dan Preventive Behavior Scale (? = 0.886). Data yang diperoleh melalui kuesioner dianalisis menggunakan teknik analisis data uji regresi linear sederhana. Hasil penelitian menunjukan bahwa variabel health consciousness memiliki peran yang signifikan terhadap variabel preventive health care behavior (p = .000, R2 = .219). Artinya, individu obesitas yang memiliki kesadaran kesehatan akan berupaya untuk melakukan tindakan pencegahan demi menjaga kesehatan. Oleh sebab itu, seseorang yang mengalami obesitas perlu mengembangkan health consciousness pada dirinya, sehingga dapat termotivasi dalam melakukan preventive health care behavior.
... Specifically, participants in the cue-rich environment consumed an average of 219.97 additional calories compared to those in the neutral environment. Consumption of only 148 additional calories per day can lead to a gain of 15 pounds per year (Wellman & Friedberg, 2002). Thus, exposure to the ubiquitous food cues in the American food environment could, over time, lead to weight gain through accumulation of small daily increases in consumption. ...
Obesity is a substantial problem in the U.S., with growing rates particularly at early developmental stages (e.g., childhood, adolescents). Several factors may contribute to the development of overeating and obesity, including elevated craving in response to food-related cues, individual susceptibility to food-related cues, and neural changes associated with behavioral phenotypes implicated in obesity. The current dissertation aims to shed light on these contributing factors, in an effort to better understand obesity risk and contribute to the development of effective interventions. Study 1 aimed to test the incentive-sensitization theory of addiction by examining food motivation, hunger, and consumption in a cue-rich compared to neutral environment. Participants (n = 126) were randomized to either a naturalistic fast-food laboratory or a neutral laboratory, where they provided self-reported ratings of “wanting,” “liking,” and hunger, and engaged in a task assessing food motivation and food consumption. Study 1 found that “wanting,” hunger, and consumption were greater in the cue-rich compared to neutral laboratory, while “liking” did not differ between conditions. This study provides support for the incentive-sensitization theory as applied to eating behavior. Study 2 developed and tested a novel paradigm for identifying two phenotypes of cue-responsivity, sign-tracking and goal-tracking. Children aged 5-7 (n = 64) engaged in a Pavlovian conditioning task designed to assess propensity to engage with a cue (sign-tracking) versus the location of a reward (goal-tracking). Children then engaged in tasks assessing food motivation and inhibitory control. Contrary to hypotheses, Study 1 did not find a distinct goal-tracking phenotype, and did not find sign-tracking behavior to be associated with either food motivation or inhibitory control. Considerations for how to examine these phenotypes in future research are discussed. Study 3 examined how resting state functional connectivity (rsFC) relates to obesity, food consumption, food motivation, and inhibitory control in adolescents (n = 164) aged 13-16 who ranged from lean to obese. Participants completed tasks assessing food motivation and inhibitory control, then on a second visit underwent a resting-state scan and then completed a food consumption task in a cue-rich environment. Obesity and elevated food motivation were found to be marked by altered connectivity in areas in the salience network (e.g., caudate, NAcc, OFC) and the default mode network (e.g., PCC, hippocampus). However, obesity was not found to be associated with behavioral outcomes, thus these behaviors were not found to mediate associations between obesity and rsFC patterns. These findings provide suggestions as to effective prevention and intervention targets. The current dissertation provides evidence for a strong role of elevated food motivation (especially in the context of food cues) in the overconsumption of palatable foods. Clinical implications and suggestions for intervention are discussed.
... This can be does not follow up the routine management may regain it; so, in-order not to regain it after sometime must be consistence. This could bring drastic change to obesity reduction, thereby processing a healthier weight [8][9][10]. ...
PCOS has affected 116 million women and still counting, that is about 3.4% of the entire global population, as reported by the World Health Organization (WHO) in 2012. It is a common and the leading cause of inability to get pregnant among women in their reproductive age. It is a complex phenomenon as it combines the environment, behavior, genetic, and physiological factors of health that are intertwined producing a phenotypic heterogeneous issue. Very few literatures have reported on practice adherence to reduce weight which are combined strategy in combating PCOS. Objective: knowledge and practice towards weight reduction among women with polycystic ovarian syndrome. Method: The review adopted the PRISMA strategy "the preferred reporting item for systematic reviews". Inclusion identified (knowledge, practice, women, and PCOS) articles were selected within 5 years from 2016 to 2020. Search engines like Google Scholar, PubMed and open access were used. Descriptive analysis was conducted on the10 articles identified for qualitative synthesis. Result: There were 10 articles eligible who represented a total of 3553 participants. Evidence reports an increasing trend as majority of the articles were from the year 2020 and from the US. Half of the studies did not report the sampling techniques. 67% were willing to recommend or use alternative medicine and satisfied with relief due to exercise and diet change. Similarly, PCOS care showed less knowledge by physician awareness of the breadth of PCOS. Furthermore, treatment options revealed that 73% among PCOS women were in Bangladesh, and life style medication was practiced by 35%. More than half of the population were not aware of PCOS, had irregular periods which was a symptom of PCOS, and complications were faced by 70%. Of which, 20% were diagnosed with PCOS and more that 80% managed with health diet according to the report. Similarly, PCOS was associated with susceptibility, weight gain, poor control of health, and lower benefit of health behavior. 47% attempted government diet and there was not any change. Conclusion: Therefore knowledge gaps of PCOS need to be emphasized, especially among the physicians, to effectively manage the health issue for patients. Considerable strategy information, education, awareness and counseling are needed at all the levels. For instance, at the facility, institutional, governmental, non-governmental, hospitals staffs and individuals regarding PCOS and policy implications, management and screening should be made mandatory.
... A morbidly obese individual is one with body mass index(BMI) (ratio of individual height to weight about 40 and more or the ratio is 35 and more with comorbidities and obesity related problems such as arterial hypertension, diabetes,cardiovascular diseases and hyperlipidemia. An individual is also considered morbidly obese when the body weight is 100 pounds over the ideal body weight [1,2]. ...
Background
Obesity could affect many functions of the body systems, particularly respiratory system. Effect of obesity on respiratory system leads to an impairment in pulmonary function tests which is represented by a decrease in lung volumes and capacities, therefore obstructive or restrictive pulmonary diseases may develop. The recent study was conducted to investigate and assess the impact of weight loss by surgery on static and dynamic lung volumes (pulmonary function tests) and the improvement in co morbidities.
Patients and methods
The study included 68 morbid obese patients, 36 females and 32 males. The patients were with age range 24–56 years, BMI≥ 40 kg/m²or≥35 kg/m² with co morbidities. Pulmonary volumes and function tests of all patients were measured before weight loss surgery and one year after the surgery.
Result
The results showed a significant reduction in the body weight (p < 0.05), with an improvement in co morbidities. Pulmonary volumes ERV,IRV,TLC, FRC and RV were significantly changed one year after surgery as well as there were significant increases in the mean values of the dynamic volumes such as FEV1,FEV1%,FEF50%, PEF and MVV.(p < 0.05).
Conclusion
loss of excess body weight by bariatric surgery resulted in a significant improvement in co morbidities and function of respiratory system represented by significant changes in both static and dynamic lung volumes …
... Esse estigma social se correlaciona negativamente a outras dimensões da vida da pessoa com sobrepeso ou obesidade, incluindo escolaridade, status socioeconômico e estado civil, contribuindo significativamente para piora da qualidade de vida 40,41 . Alguns estudos revelaram que pessoas com sobrepeso e obesidade têm piores condições de trabalho, menores salários e menores chances de serem contratadas, se comparadas com indivíduos com peso considerado normal 42 . ...
Sobrepeso e Obesidade em Adultos
Portaria SCTIE nº 53 - 11/11/2020
... With the continuous improvement of people's living standards, the occurrence of obesity and related metabolic diseases has become one of the important factors that endanger human health 4,5 . Studies have shown that excessive accumulation of triglyceride content in fat cells may cause obesity, which increased the risk of many diseases such as insulin resistance 6,7 , type 2 diabetes 8 , cardiovascular disease 9 , and hypertension 10 . ...
Long noncoding RNAs (lncRNAs) have been discovered to play a key role in adipogenesis, while the role of lncRNA human leukocyte antigen complex group 11 (HCG11) in adipocyte differentiation has not been studied clearly. We used human adipose-derived mesenchymal stem cells (hAdMSCs) to establish a model of cell differentiation in vitro and found that expression of lncRNA HCG11 was decreased during adipogenesis through real-time quantitative polymerase chain reaction analysis. Then, hAdMSCs were transfected with pcDNA-HCG11 or HCG11-shRNA (sh-HCG11); the adipogenic marker proteins were detected by Western blot, and the activity of lipogenesis enzymes was detected by spectrophotometry. The expression of CCAAT-enhancer-binding protein α, fatty acid-binding protein, peroxisome proliferator-activated receptor gamma 2 and the levels of acetyl coenzyme A carboxylase and fatty acid synthase FAS were significantly downregulated in hAdMSCs at different stages transfected with pcDNA-HCG11, while knockdown of lncRNA HCG11 promoted adipocyte differentiation. Bioinformatic analysis indicated that miR-204-5p was a potential target gene of HCG11, which was confirmed by luciferase reporter gene analysis and RNA pull-down analysis. In addition, miR-204-5p directly targeting the 3′-untranslated region of SIRT1 was also predicted by StarBase and verified by luciferase reporter gene analysis. Enforced expression of miR-204-5p negatively regulated the SIRT1 protein level. Furthermore, SIRT1 overexpression significantly inhibited adipogenic marker protein, levels of lipogenesis enzymes, and the proliferation of hAdMSCs. When pcDNA-HCG11 and miR-204-5p mimic were co-transfected into hAdMSCs, we found that the miR-204-5p mimic reversed the suppressor effect of pcDNA-HCG11. Taken together, we found that HCG11 negatively regulated cell proliferation and adipogenesis by the miR-204-5p/SIRT1 axis. Our findings might provide a new target for the study of adipogenesis in hAdMSCs and obesity.
... Moreover, serious rise in obesity would increase the cost of healthcare for society and the government. 26 Currently, it is generally believed that lifestyle and diet are the primary causes of overweight or obesity, 8,27 and that the future solution for such epidemiological issues should come from policies based on prevention of those aspects related to health and social customs surrounding being overweight or obese. For example, the "vegetable-rich" southern dietary pattern associated with a low-fat intake is beneficial for Northerners. ...
Objective: Determining geographical distribution and local dietary patterns involved in being obese is useful for designing intervention strategies. Methods: We selected residents between 18 and 65 years old from 11 Chinese provinces to compare dietary patterns and BMI from the China Health and Nutrition Survey packages in 2011. We used linear and logistic regression analyses to assess the strength of association among geographic variables, the obesity problem, and dietary patterns. Results: The overall prevalence of overweight and obesity in the North was 10.51% higher than that in the South. Northern dietary patterns feature a high intake of wheat and soybeans, whereas southern dietary patterns feature a high intake of rice, vegetables, meat, and poultry. The estimated coefficient of regional variables on dietary score is 1.49, the estimated coefficient of regional variables on the odds ratio for being overweight is 1.68 and for being obese is 2.04. Multivariate logistic regression including both variables of South-North areas and northern dietary patterns showed a significant correlation with being overweight or obese. Conclusions: Northern areas and their local dietary patterns are more likely to contribute to overweight and obesity. Our study provides empirical evidence for policies that target the ''obesogenic'' environment and promote opportunities for persons to access healthy dietary patterns and nutritional balance.
... The possible explanation for increase in body size is because of decreased metabolic rate with ageing and accumulation over the years of unburned calorie intakes. Environmental factors such as eating high-fat foods or lack of exercise, as well as Sedentary Lifestyle Syndrome (SeDS) could also be accountable for increasing in body size [43]. These possible explanations are compatible with the considerable social and life style changes that have occurred across the UK over the last 30 years. ...
Introduction
Previous evidence has suggested a relationship between male self-reported body size and the risk of developing prostate cancer. In this UK-wide case-control study, we have explored the possible association of prostate cancer risk with male self-reported body size. We also investigated body shape as a surrogate marker for fat deposition around the body. As obesity and excessive adiposity have been linked with increased risk for developing a number of different cancers, further investigation of self-reported body size and shape and their potential relationship with prostate cancer was considered to be appropriate.
Objective
The study objective was to investigate whether underlying associations exist between prostate cancer risk and male self-reported body size and shape.
Methods
Data were collected from a large case-control study of men (1928 cases and 2043 controls) using self-administered questionnaires. Data from self-reported pictograms of perceived body size relating to three decades of life (20’s, 30’s and 40’s) were recorded and analysed, including the pattern of change. The associations of self-identified body shape with prostate cancer risk were also explored.
Results
Self-reported body size for men in their 20’s, 30’s and 40’s did not appear to be associated with prostate cancer risk. More than half of the subjects reported an increase in self-reported body size throughout these three decades of life. Furthermore, no association was observed between self-reported body size changes and prostate cancer risk. Using ‘symmetrical’ body shape as a reference group, subjects with an ‘apple’ shape showed a significant 27% reduction in risk (Odds ratio = 0.73, 95% C.I. 0.57–0.92).
Conclusions
Change in self-reported body size throughout early to mid-adulthood in males is not a significant risk factor for the development of prostate cancer. Body shape indicative of body fat distribution suggested that an ‘apple’ body shape was protective and inversely associated with prostate cancer risk when compared with ‘symmetrical’ shape. Further studies which investigate prostate cancer risk and possible relationships with genetic factors known to influence body shape may shed further light on any underlying associations.
... Obesity has become a major public health challenge whose prevalence doubled since 1980s in the world [268,269]. Increased obesity rate burdens the health care system by increasing the expense for treating obesity-related comorbidities and rises the indirect social costs for the loss of productivity from being absent in work for illness [268][269][270]. In 2017 to 2018, over 40% of Americans were obese from aged 20 to 60 and over [271]. ...
There are two essential fatty acids for humans, a-linolenic acid (ALA) and linoleic acid (LA), which should be taken from foods to maintain health. Once incorporated into cells, ALA and LA, which are omega-3 poly unsaturated fatty acid (n-3 PUFA) and n-6 PUFA respectively, undergo elongation and desaturation to generate longer and more unsaturated fatty acids influencing inflammation and immunological responses. Numerous studies showed a dietary reduction of n-6/n-3 PUFA ratio improves cardiovascular health, inflammation, and insulin resistance. Fish oil, the main resource for n-3 PUFA, is shown to increase these health benefits. In our lab, we investigated the efficacy of ALA-enriched butter (n3Bu) as an alternative to fish oil for n-3 PUFA. n3Bu-fed mice showed increased bioconversion of ALA to long-chain n-3 PUFA (LC n-3 PUFA) and attenuated high fat (HF) diet-induced insulin resistance and inflammation. Besides, these health benefits, n-3 PUFA is shown to improve obesity and its related diseases by regulating lipid metabolism in both white adipose tissue (WAT) and brown adipose tissue (BAT). Fish oil abundant with n-3 PUFA promotes BAT formation and increases its thermogenic activity in cold acclimation. However, the impact of ALA-enriched agricultural products on the BAT function is unknown. In this study, we investigated the effect of ALA-biofortified butter (n3Bu) on lipid metabolism and thermogenic functions in BAT. Intake of n3Bu significantly reduced the whitening of BAT and increased the thermogenesis in response to acute-cold treatment. Consumption of n3Bu promoted bioconversion of LC n-3 PUFA, fatty acid elongation and desaturation, and mitochondrial biogenesis. Taken together, our results support that ALA-biofortified butter is a novel source of n-3 PUFA that potentiates the BAT thermogenic function. Advisor: Sathish Kumar Natarajan
... Obesity has been associated with a higher risk of cancer [3], cardiovascular diseases, and mortality [4]. Besides, obesity is associated with critical economic costs (related to preventive, diagnostic and treatment services) and negative psychosocial consequences such as social stigma and depression [5,6]. Several factors contribute to obesity in adults, including excessive energy consumption not only in portion sizes but also in the number of processed food items [7] and decreased physical activity that leads to decreased number of expended calories [8]. ...
Short and long sleep duration have been associated with risk of obesity in children and adolescents. Evidence in adults is more mixed, with biological and psychosocial factors underlying these relationships mostly unknown. This review aimed at qualitatively and quantitatively summarizing previous studies on sleep duration as a predictor of obesity in adults in order to provide an update of the state of art in this field and clarify these relationships. Odds ratios at 95% Confidence Intervals (CI) were estimated using random-effects models. Heterogeneity of effects distribution and publication bias were tested. Twelve articles were selected for short sleep (n = 154,936) and eight for long sleep duration (n = 152,192). Results indicated that short sleep duration (OR: 1.412; 95% CI: 1.177–1.694) was significantly associated with the risk of future obesity, and that long sleep duration (OR: 0.995; 95% CI: 0.889–1.114) was not associated. Heterogeneity was high and lowered to non-significant values when considering gender and extremes of short/long sleep duration. Results seem to confirm a potential role of short sleep duration in predicting but results on long sleep are still mixed. Future investigations on potential mediators of such relationships are needed.
... With the continuous improvement of people's living standards, the occurrence of obesity and related metabolic diseases have become one of the important factors that endanger human health [4,5]. Studies have shown that excessive accumulation of triglyceride content in fat cells may cause obesity, which increased the risk of many diseases such as insulin resistance [6,7], type 2 diabetes [8], cardiovascular disease [9] and hypertension [10]. ...
Background: LncRNAs have been discovered to play a key role in adipogenesis, vital in regulating adipose developmen t. Numerous evidences show that adipogenesis is the leading cause of obesity, while the role of lncRNA HLA complex group 11 ( HCG11 ) in adipocyte differentiation has not been elucidated.
Methods: hAdMSCs were used to establish a model of cell differentiation in vitro . Expression of lncRNA HCG11 was detected by RT-qPCR analysis. Transfection of the shRNA targeting HCG11 or pcDNA-HCG11 into hAdMSCs was also assessed. The adipogenic marker proteins C/EBPα, FABP4 and PPARγ2 and important inflammatory factors IL-6 and TNF-α were detected by Western blot. Bioinformatics analysis predicted the target genes of HCG11 and mir-204-5p, which was confirmed by luciferase reporter gene analysis and RNA pull-down analysis.
Results: Here we show that lncRNA HCG11 was decreased as the degree of adipogenesis. The expression of C/EBPα, FABP4 and PPARγ2 were significantly downregulated transfected with pcDNA-HCG11 in hAdMSCs at different stages, while knockdown lncRNA HCG11 can promote adipocyte differentiation. In addition, miR-204-5p was a potential target gene of HCG11 and SIRT1 could directly target miR-204-5p. Overexpression of SIRT1 or transfected with agonists of SIRT1 (Res) significantly inhibited adipogenic marker protein levels and inflammatory responses, and the proliferation of hAdMSCs were also inhibited. pcDNA-HCG11 and miR-204-5p mimic were co-transfected into hAdMSCs, we found that miR-204-5p mimic reversed the suppressor effect of pcDNA-HCG11.
Conclusion: Our findings showed that HCG11 negatively regulated cell proliferation, inflammatory responses and adipogenesis by miR-204-5p/SIRT1 axis. And our findings may provide a new target for the study of adipogenesis in hAdMSCs and obesity.
... Much of the high prevalence of obesity can be attributed to poor dietary patterns and lack of physical activity (Popkin et al. 2006). There are high physical, financial, and emotional costs for those who are obese, which can be directly or indirectly measured (Finkelstein, Ruhm, and Kosa 2005;Popkin et al. 2006;Wellman and Friedberg 2002). Obesity can also lead to other conditions and chronic diseases, including cancer, cardiovascular disease, type II diabetes, osteoarthritis, and osteoporosis (Popkin et al. 2006). ...
Nonprofit organizations have the potential to influence public health by filling voids not filled by government or private organizations. Here we investigate whether the presence of health-related nonprofit organizations at the local community level helps to improve community-level obesity. This study used a time-series design using a random effects model to determine whether the entrance or exits of health nonprofits at the county level was associated with lower obesity rates in the US one and two years following the entrance or departures of nonprofits. The effect was small but significant in urban areas, with a smaller effect in rural areas. Our findings suggest that the presence of health nonprofits is associated with positive health outcomes, in this case obesity. The plausibility may be explained through the increased role nonprofits play in fostering social capital and increased promotion of health-related issues.
... Rates of overweight and obesity are rising among college students. 1,2 Aside from the negative physical health outcomes associated with overweight and obesity, 3 mental health can also suffer. 4 In fact, the mere perception or classification that one is (has) underweight or overweight, regardless of the accuracy of the perception or classification, can also negatively impact one's health. ...
Objectives: Examine the prevalence of body weight perception discordance, and its relationship with physical activity and mental health among college women.
Participants and methods: Data were collected from a convenience sample of female undergraduates enrolled in general education health and wellness courses at a large, northeastern United States university (n = 1607) via direct email using previously validated measures that assessed: demographics; physical activity; weight goals and perceptions; mental health and sleep; and, physical activity enjoyment, self-efficacy, and goal setting. Analyses included one-way analysis of variance analyses and chi-square tests for independence.
Results: Though most women had accurate weight status perceptions (n = 987, 62.6%), there was a tendency to overestimate weight status (n = 482, 31.2%) that was associated with greater depressive symptoms.
Conclusion: A relatively large minority of women demonstrated discordant weight status perceptions, which were associated with adverse mental health outcomes. Colleges should consider improving healthy weight status perception education among women to improve mental health.
... Furthermore, the prevalence of obesity and its consequences have increased in the last decade irrespective of socio-economic status, income and education levels [12]. In the USA, obesity and associated non-communicable diseases (NCDs) have a major impact on economic and social states; about 120 billion USD was the estimated cost, with two thirds accounting for the cost of treatment plans and one third for the cost of disability [13]. The rates of obesity have tripled in the last 20 years in the developing world, where the Middle East and Asia-Pacific regions are facing the greatest challenges [14]. ...
Objectives
To describe the distribution of social factors, lifestyle habits and anthropometric measurements according to hypertension and Type-2 diabetes.
Methods
A cross-sectional study was conducted in Gaza City, Palestine that included 379 patients (20–60 years) who had hypertension and/or diabetes. Three groups of patients were involved; 106 hypertensive (HT), 109 diabetic (T2DM) and 164 hypertensive diabetics (HT + T2DM).
Results
The HT + T2DM group were older and had a higher body mass index compared to HT and T2DM groups. There were 62.3% patients who were female, 49.2% were highly educated HT patients, and 49.3% patients had a low level of education and were HT + T2DM. There were 55.8% patients who lived in large families. Patients who were passive smokers or never smoked before were mostly HT + T2DM, while active smokers and past smokers had T2DM. There were 48.2% patients who were highly physically active who had HT, 40.9% whom were moderately active had T2DM, and 53.8% of patients who had a low level of activity were HT + T2DM. Multivariate linear regression showed that having a diseased mother, living in a large family, being a past or passive smoker, or never having smoked, having a low or moderate level of activity, and having HT or HT + T2DM, were significantly associated with an increased body mass index.
Conclusion
Parental health/disease conditions and environmental factors (social network and lifestyle habits) played the greatest role in the development of obesity and disease.
... Obesity is a major health risk that is linked to several lifethreatening diseases, including stroke, type 2 diabetes, hypertension, coronary artery disease, and a number of different cancers [12]. e United States has one of the highest rates of obesity in the world, with more than one-third of US adults classified as obese [13]. is growing phenomenon is concerning, with obesity now ranking as the seventh leading cause of death in the United States [14], with approximately 300,000 deaths directly linked to obesity each year [15]. Furthermore, people with obesity have medical costs 30% higher than those of a healthy weight [16]. ...
Factors associated with chronic obstructive pulmonary disease (COPD) among never-smokers have received little research attention. One potential risk factor for COPD is obesity, which is of particular importance in light of the global obesity epidemic. The objective of this study was to investigate the association between COPD and levels of obesity in a nationally representative sample of non-Hispanic white never-smokers. Data were drawn from the 2012 Center for Disease Control’s Behavioral Risk Factor Surveillance System (BRFSS). Pearson’s chi-square tests and logistic regression analyses were conducted in a large nationally representative sample of non-Hispanic white respondents aged 50 and over (76,004 women; 37,618 men) who reported that they had never smoked. A dose-response relationship was observed for both men and women: the prevalence of COPD increased from 2.5% in men and 3.5% in women who were of a healthy weight (BMI < 25) to 7.6% in men and 13.4% in women who had a BMI of 40 or higher. Even after adjusting for 7 potential confounds (e.g., age, education, and income), the odds of COPD were 3.21 higher for men (95% CI = 2.46, 4.20) and 4.00 higher for women with class III obesity (95% CI = 3.52, 4.55) in comparison with those of healthy weight. Regular screening for COPD is warranted in never-smoking obese patients who are aged 50 and over. Future research is needed to investigate plausible mechanisms for this association, including (1) the role of chronic inflammation associated with obesity and (2) the impact of central obesity on respiratory system mechanics.
... The medical cost of obesity in America rose from $78.5 billion dollars in 1998 to estimated $147 billion dollars in 2008 [20]. In fact, morbidities associated with obesity are second only to smoking in the U.S. [21]. Obesity is a risk factor for heart disease, certain cancers, stroke, metabolic syndrome, insulin resistance, high blood pressure and non-alcoholic fatty liver disease [22,23]. ...
Obesity is a state of chronic inflammation influenced by lipids such as fatty acids and their secondary oxygenated metabolites deemed oxylipids. Many such lipid mediators serve as potent signaling molecules of inflammation, which can further alter lipid metabolism and lead to carcinogenesis. For example, sphingosine-1-phosphate activates cyclooxygenase-2 in endothelial cells resulting in the conversion of arachidonic acid (AA) to prostaglandin E2 (PGE2). PGE2 promotes colon cancer cell growth. In contrast, the less studied path of AA oxygenation via cytochrome p450 enzymes produces epoxyeicosatetraenoic acids (EETs), whose anti-inflammatory properties cause shrinking of enlarged adipocytes, a characteristic of obesity, through the liberation of fatty acids. It is now thought that EET depletion occurs in obesity and may contribute to colon cell carcinogenesis. Meanwhile, gangliosides, a type of sphingolipid, are cell surface signaling molecules that contribute to the apoptosis of colon tumor cells. Many of these discoveries have been made recently and the mechanisms are still not fully understood, leading to an exciting new chapter of lipidomic research. In this review, mechanisms behind obesity-associated colon cancer are discussed with a focus on the role of small lipid signaling molecules in the process. Specifically, changes in lipid metabolite levels during obesity and the development of colon cancer, as well as novel biomarkers and targets for therapy, are discussed.
... Obesity contributes significantly to the global burden of disease and increases the risk of heart disease, Type II diabetes and cancer (Bean, Stewart, & Olbrisch, 2008;Brownell & Gold, 2012;Klein et al., 2007;Wellman & Friedberg, 2002;Zhang & Wang, 2004). The alarming increase in obesity over the last three decades has been linked to the availability, accessibility and affordability of inexpensive, energy-dense snack foods (Afshin et al., 2017;Drewnowski & Darmon, 2005). ...
... There is an expansive body of scholarship that supports the notion that women's experiences are shaped and influenced by both their gender and the experience of inhabiting their bodies. Wellman and Friedberg (2002) argue that obesity is not gendered, however, it is indisputable that the experience of living in larger bodies is. Thus, inclusion for the study was based on clothing size, gender and age, calling for female participants who were over the age of 18, and who wore above a women's size 16 in clothing size (Size 16 was commonly the largest size available in mainstream women's clothing at the majority of retail outlets in the research location at the commencement of the project). ...
Despite an increasingly pathologised discourse on overweight and obesity, the clinical experiences of large bodied individuals remain relatively unexplored. In addition, interventions targeting overweight and obesity have generally failed to recognise the role that weight related discrimination and stigma play in both the uptake of interventions and the experience of healthcare consumers. This Australian research used a grounded theory approach, informed by constructivism, to further understanding and generate dialogue about the experiences of large bodied female healthcare consumers. Participants included 22 women, who were purposively sampled, all of whom identified as overweight or obese. Data was collected from two major sources: intensive interviews with participants and literature. For the participants in this study, being overweight or obese created a significant barrier to positive clinical interactions with their medical professionals. Women described their interactions with medical professionals, particularly general practitioners (GPs) as the most challenging to manage. Participants believed that when they became patients, they were defined by their body size, which worked to create a one-dimensional identity – that of a fat patient. These findings suggest that weight-related discrimination and stigma has a significant impact on both the clinical interaction, and the health and wellbeing of large bodied, female healthcare consumers.
... Thus, work has an influence on the social dimension (defined as the ability to maintain proper relationships with other people and to fulfil social roles) and the mental dimension of health (connected, for example, with the ability to think clearly and logically, to recognise feelings and express them properly, and the ability to cope with stress, depression and fear). The actions taken by the employers for the benefit of a good work environment and promotion of health (e.g. in the form of incentive sports programmes) connected with social networking effects, affect health condition and the situation on the labour market (Wellman, Friedberg, 2002;Lechner, 2009). ...
Health condition is an important area of social life. Employees in good health work more efficiently and effectively than sick ones. It is widely accepted that health is one of the elements of hu‑ man capital and a factor in determining the situation of the individual in the labour market. The main objective of the research is to analyse the health status of household members in the context of their professional activity. The working hypothesis assumes that people suffering from health problems are rather economically inactive than unemployed. In the paper an attempt is made to identify fac‑ tors (related to eg. health) which affect the probability of being economically inactive. To achieve the objective of the paper individual data of household members from the European Survey on Income and Living Conditions (EU‑SILC) conducted by Central Statistical Office in Poland in 2013 was used. The results of the analysis indicate that in general, deterioration of health increases the risk of remaining economically inactive. In the analysis of the order of importance of factors affecting economic inac‑ tivity, the ones connected with health turned out to be of the greatest importance.
... The worldwide prevalence of obesity has nearly doubled since 1980, according to the World Health Organization [2]. Obesity results in a host of health consequences such as cardiovascular disease, diabetes, hypertension, and causes social consequences including depression and psychological pain [3,4]. ...
Obesity is a global pandemic that brings about a myriad of health consequences. In the past, policies for combating obesity mainly focused on improving individual health and behavior, but nowadays some policies have changed and now concentrate on improving the built environment believing this can improve health through positive changes to health-related behaviors. We examined whether both individual and environmental factors were associated with body mass index in Seoul, the capital city of South Korea. Data from the 2011 and 2013 Community Health Surveys were used (n = 20,147 men and 25,300 women). We staged multilevel logistic regression models to estimate the effect of individual and environmental factors on obesity. Among individual covariates, high-risk drinking, the time spent watching TV and surfing the Internet, high salt intake, stress, and the negative recognition of health were significantly associated with obesity. When controlling individual covariates, the number of sports facilities, number of fried chicken stores, and food insecurity level were statistically associated with probability of obesity. Therefore, this study emphasizes that it is important not only to improve the health behavior of the individual, but also to improve the urban environment in order to reduce the obesity rates of city dwellers.
... Obesity among young individuals is not only a risk factor for obesity later in life, but also leads to many typical adult conditions such as hypertension and diabetes [5]. Besides being exposed to many physical illnesses, obese children and adolescents often present emotional distress and low self-esteem since they encounter prejudice at school [6]. Moreover, while attempting to lose or control their weight, teenagers tend to develop self-image dissatisfaction and unhealthy weight control behaviors (e.g skipping meals, fasting, taking diet pills or smoking cigarettes, vomiting) [7,8]. ...
Purpose:
To conduct a cluster randomized controlled trial comparing the Brazilian version of the New Moves program (NMP) versus observation among Brazilian adolescent girls.
Methods:
Ten schools were randomly allocated to the Brazilian NMP or the observation arm. Study participants included 12-14-year-old girls. Recruitment occurred between February 2014 and March 2015. The NMP included sports, nutritional support, motivational interviews, collective lunch, and parental information materials. Our main outcome was the Body Shape Questionnaire (BSQ). Secondary outcomes included the Rosenberg Self-Esteem Scale and the Unhealthy Weight-Control Behaviors Index, as well as body mass index. Study results were evaluated through generalized estimating equations.
Results:
A total of 270 adolescents participated in the study. At baseline, mean age was 13.4 years, and average BMI was 21.4. The intervention did not result in any statistically significant differences between the NMP and the observation arm, including BSQ (predicted means of 64.33 - IC 95% 59.2-69.47 vs. 62.02 - IC 95% 56.63-67.4), respectively) and our secondary outcomes. Adherence was low during the intervention (32.9%) and maintenance (19.1%) phases of the program.
Conclusion:
The New Moves program did not lead to significant changes in our measured outcomes. Future studies should investigate whether changes might occur when comprehensive behavioral programs are sustained over longer periods while also being customized to local population characteristics.
... Obesity is a major cause of preventable deaths (Flegal et al., 2004), and most often occurs due to overconsumption of calories along with decreased physical activity. Past research has examined differences in reported calorie intake, but this work has most often classified individuals solely on the basis of their demographic information (Mokdad et al., 2003;Wellman and Friedberg, 2002). While the causes and consequences of obesity are fairly well-known, advanced segmentation techniques that include an examination of more variables than individual demographics are well-positioned to offer an improved understanding of the factors that influence consumption. ...
Purpose
The purpose of this paper is to study the behavioral and lifestyle influences on reported calorie intake. Marketing segmentation techniques applied to self-reported food consumption can offer benefits to both health policy and marketing research.
Design/methodology/approach
The two-stage modeling process in this research determines important behavioral, lifestyle and sociodemographic influences on reported calorie intake. Significant predictors are then included in latent class models, which are used to derive and describe five consumer segments.
Findings
These segments differ with respect to their food-related activities, such as dieting, grocery shopping and preparing food at home. The segments also differ with respect to lifestyle characteristics, such as household size, employment status and income. Data obtained from a multi-period probability sample help generalize the results to the US population.
Originality/value
The models developed in this paper can inform health policymakers by explaining reported calorie intake patterns more thoroughly than demographics alone, aiding their ability to create more targeted interventions. This approach also allows food marketers to clarify consumer insights that can be used for targeting particular food shopper segments.
The United States faces a growing public health crisis with rising rates of overweight and obesity, despite advancements in nutritional science, dietary supplements, and prescription weight loss medications. This article explores the paradox of increasing obesity amidst seemingly abundant solutions, supported by recent statistics and scientic insights. It examines factors such as dietary habits, physical inactivity, socioeconomic inuences, and psychological aspects contributing to the obesity epidemic. The role of nutrition, the efcacy of dietary supplements and weight loss drugs, and technological innovations are analyzed. Additionally, government interventions, public health campaigns, and community programs are assessed for their impact. Despite the challenges, future directions emphasize the need for integrated approaches combining technological, psychological, and sociocultural factors to effectively address the root causes of obesity and promote sustainable weight management.
This study aims to investigate the anti-obesity properties of lactic acid bacteria (LAB) isolated from fermented dairy products such as “Airag” and “Khoormog” in Mongolia. These traditional dairy products are widely used in Mongolia and believe in having potential probiotic, anti-diabetes, anti-cancer, and anti-tuberculosis properties and are made from unheated two-humped camel milk and mare milk, respectively. We chose three LAB strains based on their probiotic characteristics, including tolerance of gastric and bile acids. Then we checked the anti-obesity activity of probiotic strains in vivo. An animal model was evaluated in twenty male C57BL/6J mice by inducing obesity with a high-fat diet (HFD), which was divided into five groups: regular diet group (Negative control), HFD group (Positive control), HFD with Lacticaseibacillus paracasei X-1 (X-1), Lacticaseibacillus paracasei X-17 (X-17), and Limosilactobacillus fermentum BM-325 (BM-325). For six weeks, 5 × 109 colony-forming units (CFU) of bacteria were given orally to the LAB-fed groups. Fasting blood glucose (FBG), lipid profiles, organ index, and organ morphology were all measured. The probiotic strains suppressed growth in adipose cell volume, stabilized FBG, reduced liver cell degeneration, and slowed HFD-induced body weight gain. The results suggest that some strains increase general metabolism while lowering body weight.
The increments in the prevalence of the overweight population are alarming as the high level of body weight and adiposity are often associated with an increased risk of developing numerous health complications. Most adults did not engage in regular physical activity due to reasons such as time constraints. Therefore, this study aimed to investigate the effects of short-duration resistance training to voluntary failure for three weeks on muscle strength adaptations. Ten overweight men (age 23 ± 4 years; height 171.6 ± 4.7 cm; weight 80.6 ± 5.8 kg; body mass index (BMI) 27.4 ± 1.2 kg m−2) were recruited for this study. The resistance exercise training involved one session per week for three weeks. Each training session involved three sets of eight exercises, performed at 80% of 1-RM to voluntary failure and lasted about 30 min. Muscle strength test was performed at baseline and post-intervention using 1-RM protocol. Muscle mass and body adiposity measurements were taken at baseline, each week after the training session and after the intervention. At the end of the intervention, muscles strength and mass increased by 6.9% and 0.4%, respectively, from baseline. The body adiposity decreased by 0.4% after the intervention. In conclusion, once-weekly of resistance training voluntary to failure for three weeks resulted in improvement in muscle strength and mass, and reduction in body adiposity in men with excess weight.KeywordsMuscle adaptationsMuscle massOverweight menResistance trainingVoluntary to failure
The aims of study were to analyze risk factors of carbohydrate consumption among adult women aged 19-49 years in Indonesia such as Body Mass Indexs (BMI), ages, education level, tipe of occupation, house hold income and urban-rural settlement. The study used data of the Basic Health Research (Riskesdas) 2010 of the Health Reseach and Development Agency of the Ministry of Helath, which was designed as a cross sectional survey. Total sample woman age 19-49 years was 52044 were selected for analysis. A multiple logistic regression model was applied to analyze the risk factors. The prevalence of consumption carbohidrate below 60% of energy adequancy from carbohydrate among woman was 31,6%. The results showed that the significant risk factor of carbohydrate consumption among adult woman were education level (OR for low education= 0.830, CI: 0.776-0.887), household income (OR for low income= 0.905, CI: 0.870-0.942) and urban-rural settlement (OR for rural= 0.564, CI: 0.542-0.587). Normal BMI, high education level, woman with occupation, high household income and urban settlement are protective factors for carbohydrate consumption.Â
Objective:
To identify the predictors and social problems of obese patients in Saudi Arabia.
Methods:
A cross-sectional study was conducted for the period between July 2016 and January 2017. The study population consisted of obese patients visiting the surgery clinics following the medical examinations required before obesity surgery. Patients were recruited from four main medical centres in Riyadh: King Fahad Medical City, University Medical City-King Khalid University Hospital, King Abdulaziz Medical City in the National Guard, and Prince Sultan Military Medical City. The study questionnaire tool was developed based on extensive literature. The questionnaire tool explored personal and demographic characteristics of obese patients and the social problems that morbidly obese patients suffer from at the community level. Logistic regression analysis was used to identify predictors of those facing social problems.
Results:
A total of 374 patients completed the questionnaires. We found that having a bachelor's degree, a body mass index (BMI) of 40 kg/m2 and above, and other comorbidities were important predictors that increased the likelihood of having social problems related to obesity on a community level (p<0.05). On the other hand, having a high income (11,000 SR/per month and above) was a protective factor that was associated with lower odds of having social problems related to obesity on a community level (p<0.05).
Conclusion:
Obese patients with low socioeconomic status, having a bachelor's degree, and those with comorbidities tend to have social problems. Future studies to investigate the predictors or social problems among obese patients on a larger scale are warranted.
The brain-derived neurotrophic factor (BDNF) Val66Met polymorphism is functionally related to BDNF, and is associated with obesity and metabolic complications in adults, but limited research exists among adolescents. This study comparatively examined carriers and non-carriers of the BDNF Val66Met polymorphism on body composition, energy intake, and cardiometabolic profile among adolescents with obesity. The sample consisted of 187 adolescents with obesity; 99 were carriers of the homozygous Val (G/G) alleles and 88 were carriers of the Val/Met (G/A) or Met (A/A) alleles. Cardiometabolic profile and DNA were quantified from fasted blood samples. Body composition was assessed by magnetic resonance imaging (MRI). Compared to carriers of the homozygous Val (G/G) allele, carriers of the Val/Met (G/A) or Met/Met (A/A) variants exhibited significantly higher protein (p = 0.01) and fat (p = 0.05) intake, C-Reactive protein (p = 0.05), and a trend toward higher overall energy intake (p = 0.07), fat-free mass (p = 0.07), and lower HDL-C (p = 0.07) Results showed for the first time that among youth with obesity, carriers of the Val66Met BDNF Met-alleles exhibited significantly higher C-reactive protein and energy intake in the form of fat and protein compared to Val-allele carriers, thereby providing support for the possible role of BDNF in appetite, weight, and metabolic regulation during adolescence.
Clinical Trial Registration: http://clinicaltrials.gov/, identifier NCT00195858.
Objectives:
Assess longitudinal associations between diary-measured sleep duration and clinically assessed body mass index (BMI).
Design:
Multilevel growth curve analyses examined how within-person changes and between-person differences in habitual sleep duration were associated with BMI trajectories.
Setting:
Sleep diaries across 2-6 consecutive weekday and weekend nights at each data collection point, repeatedly collected at approximate 4-year intervals, for an average of 9.2 (standard deviation [SD] = 3.6) years between 1989 and 2011.
Participants:
About 784 participants (47% women) enrolled in the Wisconsin Sleep Cohort Study (mean [SD] age = 51.1 [8.0] years at baseline).
Measurements:
The outcome variable was BMI (kg/m2). Key predictors were habitual sleep duration (defined as average weekday nighttime sleep duration) and sleep duration differential (defined as the difference between average weekday and average weekend nighttime sleep duration) at each data collection wave.
Results:
Men with shorter habitual sleep duration on weekdays had higher BMI than men with longer habitual sleep duration on weekdays (β = -0.90 kg/m2/hour, se = 0.34, p = .008). Participants with larger differentials between weekday and weekend sleep duration experienced more rapid BMI gain over time for both men (β = 0.033 kg/m2/year per hour differential, se = 0.017, p = .044) and women (β = 0.057 kg/m2/year per hour differential, se = 0.027, p = .036).
Conclusion:
This study suggests that habitual short sleep is associated with higher BMI levels in men and that a larger weekday-weekend sleep differential is associated with increasing BMI trajectories among both men and women in mid-to-late life.
Purpose: To compare nutritional habits, physical function and psychological constructs between Costa Rican older adults from urban and rural zones. Methods: Male and female older adults aged ≥ 65 yr. from urban (n = 185) and rural (n = 109) Costa Rica were assessed on nutritional habits, physical function measures, and cognitive function by a face-to-face interview. Results: Rural older adults consumed more daily carbohydrates, protein, and energy at breakfast and lunch (p < 0.05 for all), and more carbohydrates (p ≤ 0.001), fat (p = 0.002), protein (p ≤ 0.001), and energy (p ≤ 0.001) at dinner than urban elderly. Aerobic power (p = 0.044) was higher in urban compared to rural elderly. A correlation was found between aerobic power and global fatigue (r =-0.20, p = 0.014) in urban elderly. Lifetime cognitive activity correlated to total energy (r = 0.37, p = 0.003), carbohydrate (r = 0.37, p = 0.002), and protein (r = 0.34, p = 0.005) consumption in rural elderly. Higher depression scores (p = 0.048), and lower lifetime cognitive activity were observed in urban compared to rural elderly (p = 0.004). Conclusion: The health profile is positive for either group depending on the variable analyzed, except for a higher aerobic power, which provides benefits to the entire cohort.
Despite the increasing developments on human activity recognition using wearable technology, there are still many open challenges in spotting and recognising sporadic gestures. As opposed to activities, which exhibit continuous behaviour, the difficulty of spotting gestures lies in their rather sparse nature. This paper proposes a novel solution to spot and recognise a set of similar eating and drinking gestures from continuous inertial data streams. First, potential segments containing an eating or a drinking gesture are found using a Crossings-based Adaptive Segmentation Technique (CAST). Second, further to the long-established range of features employed in previous human activities recognition research work, a gesture discrepancy measure is proposed to improve the classification performance of the system. At the final step, a range of state-of-the-art classification models is employed for evaluation. Various conclusions can be drawn from the results obtained. First, given the 100% recall achieved at the segmentation step, the CAST can be considered a reliable segmentation technique for spotting drinking and eating gestures which may be employed in future gesture spotting work. Second, the addition of gesture discrepancy as a feature descriptor consistently improves the classification performance of the system. Third, the reliability of the food and drink intake monitoring approach proposed in this work finds support on the out-performance of previous similar work.
Considerando que os elevados custos com o tratamento das doenças relacionadas ao excesso de peso e obesidade têm se tornado um grande problema econômico, o objetivo deste estudo é avaliar os custos envolvidos no processo de cuidado ambulatorial dos pacientes inclusos no programa de obesidade mórbida do ambulatório de endocrinologia de um hospital público. A população do estudo é composta por pacientes inclusos no programa, e que foram acompanhados por 90 dias, sendo entrevistados e analisados seus prontuários e estrutura utilizada para o cuidado desses pacientes. Os custos foram calculados através do custeio baseado em atividades. Observou-se uma frequência maior de hipertensão e diabetes mellitus bem como quantidade de doenças, assim como maior consumo de medicamentos no período pré-operatório em relação ao pós-operatório. O tratamento ambulatorial mensal custou R346,63 comparado com R60,28, relacionado a exames. Conclui-se que o custo estrutural foi bem superior aos custos com exames e medicamentos e que a atividade de maior custo foi a de realizar serviços de recepção.
HUBUNGAN ANTARA OVERWEIGHT DENGAN NYERI PUNGGUNG BAWAH DI RSUD KANJURUHAN KEPANJEN PERIODE JANUARI-DESEMBER TAHUN 2013. Latar Belakang: Nyeri punggung bawah merupakan suatu gangguan muskuloskeletal pada daerah punggung bawah yang banyak dikeluhkan penderita yang berkunjung ke dokter. Banyak faktor yang dapat memperberat resiko terjadinya nyeri punggung bawah, salah satunya adalah
overweight. Tujuan Penelitian: Mengetahui hubungan, kuatnya pengaruh dan besarnya factor resiko antara overweight dengan nyeri punggung bawah di RSUD Kanjuruhan Kepanjen periode Januari-Desember tahun 2013. Metode Penelitian: Penelitian observasional analitik dengan pendekatan cross sectional, dengan besar sampel sebanyak 82 orang yaitu 41 penderita nyeri punggung bawah dan 41 orang lainnya penderita non nyeri punggung bawah. Analisis data dengan menggunakan statistik uji chi-square dengan á=0.05 dan uji korelasi koefisien kontingensi. Hasil Penelitian: Menunjukkan bahwa penderita dengan diagnosis nyeri punggung bawah yang datang ke RSUD Kanjuruhan Kepanjen memiliki indeks massa tubuh kategori overweight (30.5%), sedangkan sampel yang overweight tapi non nyeri punggung bawah (13.4%). Kesimpulan: Terdapat hubungan yang signifikan antara overweight dengan nyeri punggung bawah di RSUD Kanjuruhan Kepanjen periode Januari-Desember tahun 2013 (p= 0.002). Overweight memberikan pengaruh yang tidak begitu kuat (lemah) terhadap nyeri punggung bawah (r= 0.325) dan seseorang yang overweight mempunyai resiko yang lebih besar untuk mengalami nyeri punggung bawah (OR= 4.261). Kata Kunci: Overweight, Nyeri punggung bawah
There is a lot of conflicting information regarding the best way to lose weight, especially
regarding food diets. A recent study compared the different diets and ultimately revealed
that there is no significant difference in their efficacy for weight loss.
Furthermore, it is recommended to lose weight gradually because rapid weight loss was a risk factor for more rapid and important weight regain. This notion has been challenged by a study that compared the two approaches and demonstrated that the rate of weight loss has no influence on weight regain.
Ultimately, the key is to develop strategies that are best suited to the patient, so that he
can adhere more easily and maintain his efforts on the long run.
The incentive-sensitization (IS) theory proposes that “wanting” (strong motivation), more so than “liking” (hedonic pleasure), drives compulsive consumption in both substance use and overeating. Importantly, “wanting” and “liking” are only distinct in the presence of relevant cues. Cues may also contribute to overeating by increasing feelings of hunger. We employed a simulated fast-food laboratory to test IS theory by examining the effect of environmental cues on eating behavior. We tested the following hypotheses: In a cue-rich compared to neutral environment, (a) wanting would be greater whereas liking would remain the same, (b) feelings of hunger would be greater, and (c) food consumption would be greater, a relationship mediated by elevated wanting and hunger. These hypotheses were supported in the current study. Thus, contextual cues may contribute to overconsumption through increased wanting and hunger. These findings have public health implications for overeating and obesity.
Mobile health (mHealth) technologies are envisioned as self-monitoring tools of health behaviors (Kumar et al., Computer 46:28–35, 2013). They are meant to empower the individual to make sustainable behavior change that leads to better health. They are intended to be used long-term, with minimal to no supervision. This is in contrast to laboratory and clinical testing tools which are typically used short-term by physicians and researchers under strict patient constraints to resolve urgent conditions. Because of the individual-empowered focus, mHealth technologies need to meet the following design criteria: low user burden; low-cost; and long-term usability under free-living conditions. mHealth technologies present an interesting opportunity because of the high quantity of inexpensive data generated, which is far, far greater than what is typically provided by sporadic and expensive laboratory tests. In this chapter, we discuss this opportunity in the context of the development of the Bite Counter. The Bite Counter uses sensors embedded into a watch-like device to automatically track wrist motion to count bites. The device provides the user intake feedback during a meal, allowing them to self-monitor intake anywhere and anytime. The behavior change goal is to reduce intake in a way that results in healthy weight loss.
Packaging influences usage behavior long after it has influenced purchase. Managers of consumer packaged goods and public policy officials have, therefore, questioned whether a package's size influences usage volume. Although often assumed, it has never been supported. Four laboratory studies and a final study in a Laundromat identity circumstances in which larger package sizes encourage greater use than do smaller package sizes. Unit cost is a key factor mediating this relationship. After noting useful implications for decisions regarding package size portfolios, sales promotions, and public policy, the author concludes by identifying other important but overlooked factors that increase usage volume and provide research opportunities.
This study was undertaken to update and revise the estimate of the economic impact of obesity in the United States. A prevalence-based approach to the cost of illness was used to estimate the economic costs in 1995 dollars attributable to obesity for type 2 diabetes mellitus, coronary heart disease (CHD), hypertension, gallbladder disease, breast, endometrial and colon cancer, and osteoarthritis. Additionally and independently, excess physician visits, work-lost days, restricted activity, and bed-days attributable to obesity were analyzed cross-sectionally using the 1988 and 1994 National Health Interview Survey (NHIS). Direct (personal health care, hospital care, physician services, allied health services, and medications) and indirect costs (lost output as a result of a reduction or cessation of productivity due to morbidity or mortality) are from published reports and inflated to 1995 dollars using the medical component of the consumer price index (CPI) for direct cost and the all-items CPI for indirect cost. Population-attributable risk percents (PAR%) are estimated from large prospective studies. Excess work-lost days, restricted activity, bed-days, and physician visits are estimated from 88,262 U.S. citizens who participated in the 1988 NHIS and 80,261 who participated in the 1994 NHIS. Sample weights have been incorporated into the NHIS analyses, making these data generalizable to the U.S. population. The total cost attributable to obesity amounted to 51.64 billion of those dollars were direct medical costs. Using the 1994 NHIS data, cost of lost productivity attributed to obesity (BMI> or =30) was $3.9 billion and reflected 39.2 million days of lost work. In addition, 239 million restricted-activity days, 89.5 million bed-days, and 62.6 million physician visits were attributable to obesity in 1994. Compared with 1988 NHIS data, in 1994 the number of restricted-activity days (36%), bed-days (28%), and work-lost days (50%) increased substantially. The number of physician visits attributed to obesity increased 88% from 1988 to 1994. The economic and personal health costs of overweight and obesity are enormous and compromise the health of the United States. The direct costs associated with obesity represent 5.7% of our National Health Expenditure in the United States.
Individual chapters in this book provide different perspectives on the nutrition problems in the United States: what are the economic costs associated with unhealthy eating patterns; how do dietary patterns compare with dietary recommendations; how do national income and prices, advertising, health claims, and trends in eating away from home affect nutrient intake; how much do people know about nutrition and how does nutrition knowledge and attitudes affect intake of fats and cholesterol; how do different government programs and regulations influence food expenditures and consumption; what are some public and private efforts to improve healthy eating; and what are potential impacts of healthier eating on domestic agriculture.
To examine how long-term patterns of weight change affect the risk for diabetes, especially non-insulin-dependent diabetes mellitus, the authors examined the relation of weight change over a period of about 10 years (from the baseline examination in 1971-1975 until the first follow-up examination in 1982-1984) to the 9-year incidence of diabetes mellitus (1984-1992) in a national cohort of 8,545 US adults from the National Health and Nutrition Examination Survey Epidemiologic Followup Study. Diabetes incidence was identified from death certificates, hospitalization and nursing home records, and self-report. In this cohort, 487 participants developed diabetes. The hazard ratios were 2.11 (95% confidence interval (CI) 1.40-3.18) for participants who gained 5- < 8 kg, 1.19 (95% CI 0.75-1.89) for participants who gained 8- < 11 kg, 2.57 (95% CI 1.84-3.85) for participants who gained 11- < 20 kg, and 3.85 (95% CI 2.04-7.22) for participants who gained 20 kg or more compared with participants whose weights remained relatively stable. The authors found no evidence that the results differed by age, sex, or race. They estimated that the population attributable risk was 27% for weight increases of 5 kg or more. Results from this study and other recent studies suggest that the increase in body mass index in the United States that occurred during the 1980s may portend an increase in the incidence of non-insulin-dependent diabetes mellitus with important public health consequences in future years.
Obesity is a major health problem in the United States, but the number of obesity-attributable deaths has not been rigorously estimated.
To estimate the number of deaths, annually, attributable to obesity among US adults.
Data from 5 prospective cohort studies (the Alameda Community Health Study, the Framingham Heart Study, the Tecumseh Community Health Study, the American Cancer Society Cancer Prevention Study I, and the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study) and 1 published study (the Nurses' Health Study) in conjunction with 1991 national statistics on body mass index distributions, population size, and overall deaths.
Adults, 18 years or older in 1991, classified by body mass index (kg/m2) as overweight (25-30), obese (30-35), and severely obese (>35).
Relative hazard ratio (HR) of death for obese or overweight persons.
The estimated number of annual deaths attributable to obesity varied with the cohort used to calculate the HRs, but findings were consistent overall. More than 80% of the estimated obesity-attributable deaths occurred among individuals with a body mass index of more than 30 kg/m2. When HRs were estimated for all eligible subjects from all 6 studies, the mean estimate of deaths attributable to obesity in the United States was 280184 (range, 236111-341153). Hazard ratios also were calculated from data for nonsmokers or never-smokers only. When these HRs were applied to the entire population (assuming the HR applied to all individuals), the mean estimate for obesity-attributable death was 324 940 (range, 262541-383410).
The estimated number of annual deaths attributable to obesity among US adults is approximately 280000 based on HRs from all subjects and 325000 based on HRs from only nonsmokers and never-smokers.
• This report of an expert panel of the National Cholesterol Education Program provides new guidelines for the treatment of high blood cholesterol in adults 20 years of age and over. Total cholesterol levels are classified as follows: <200 mg/dL —"desirable blood cholesterol"; 200 to 239 mg/dL—borderline—high blood cholesterol; ≥240 mg/dL—high blood cholesterol. The guidelines detail which patients should go on to have lipoprotein analysis, and which should receive cholesterol-lowering treatment on the basis of their low density lipoprotein (LDL)—cholesterol levels and status with respect to other coronary heart disease risk factors. Dietary therapy is the primary cholesterol-lowering treatment. The report specifies the LDL-cholesterol levels at which dietary therapy should be started and the goals of therapy, and provides detailed guidance on the nature of the recommended dietary changes. If, after six months of intensive dietary therapy, LDL-cholesterol exceeds specified levels, drug treatment should be considered.
(Arch Intern Med 1988;148:36-69)
Smoking-attributable deaths and years of potential life lost were estimated using the formula adopted to estimate UK and US deaths caused by smoking. These estimates are based on sex-specific proportions by age of current and ex-smokers and rates of relative risk. For prevalence data we used data of 2010 STEPS survey in Georgia and Georgia Reproductive Health Survey 2005. Relative risks for potentially fatal diseases due to smoking are those that were used to estimate UK 1995 deaths. They were derived from years 1984-1988 of the Cancer Prevention Study II (CPS II). Smoking attributable mortality was estimated for year 2008, period when registration of deaths was done by adopted methods and institutions. By the calculations according to mortality data of year 2008 number of active smoking attributable deaths were 4331. Smoking is related with 10,1% of all deaths. By causes of death smoking attributed is 30% of all deaths caused by cancers, 10% of cardiovascular diseases, 9% of respiratory and 7% of digestive diseases. About 72500 potential years of life is lost in Georgia during year 2008 due to active smoking. Great majority of this burden is related with cardio vascular diseases and cancers.
Patients (n = 47) who lost 45 kg (100 lb) or more and who successfully maintained weight loss for at least three years following gastric restrictive surgery for morbid obesity viewed their previous morbidly obese state as having been extremely distressful. In spite of the strong proclivity for people to evaluate their own worst handicap as less disabling than other handicaps, patients said they would prefer to be normal weight with a major handicap (deaf, dyslexic, diabetic, legally blind, very bad acne, heart disease, one leg amputated) than to be morbidly obese. All patients said they would rather be normal weight than a morbidly obese multi-millionaire.
From both societal and payer perspectives, the economic effect of obesity in the United States is substantial, estimated at approximately 6% of our national health expenditure and cost of care in a major health maintenance organization. The number of physician visits related to obesity has increased 88% in a 6-year period. The morbidity cost (lost productivity) and functional capability of the patient with obesity is increasing rapidly (50% increase in lost productivity, 36% increase in restricted activity, and 28% increase in number of bed-days). Cost savings of treating obesity are comparable to those of treating other chronic diseases such as coronary heart disease and diabetes. Most studies indicate that most of the direct health care costs of obesity are from type 2 diabetes, coronary heart disease and hypertension. To date, however, there have been no published reports of the cost effectiveness of the medical management of obesity treatment. In conclusion, the cost of obesity is comparable to that of other chronic diseases, yet it receives disproportionately less attention. Cost effectiveness studies need to be initiated promptly.
The prevalence of obesity is increasing in America, but its impact on morbidity relative to other health risks is unclear. This paper compares the effects of overweight, poverty, smoking and problem drinking on occurrence of chronic conditions and health-related quality of life. The data were collected from a nationally representative household telephone survey of 9585 adults fielded in 1998, using self-reported measures of height and weight, poverty, smoking status, problem drinking, chronic conditions and SF-12 global scales. Regression analyses were used to estimate effects of health risk factors on morbidity. Thirty-six percent of adults are overweight but not obese (25< or =BMI<30) and another 23% are obese (BMI> or =30). Controlling for demographics, obesity is associated with more chronic conditions and worse physical health-related quality of life (P<0.01). Smoking history and poverty predict having chronic conditions, but their effect sizes are significantly smaller. Even after controlling for chronic conditions, obesity predicts physical health-related quality of life, in that case with an effect size similar to poverty. The effect of problem drinking is always smaller. Obesity is highly prevalent and associated with at least as much morbidity as are poverty, smoking and problem drinking. Nevertheless, the latter have achieved more consistent attention in recent decades in clinical practice and public health policy.
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